Resumen

WONG-MCCLURE, Roy  y  LEON-BRATTI, María-Paz. Efecto de la terapia antirretroviral en la rehospitalización por enfermedad oportunista en Costa Rica. Acta méd. costarric [online]. 2006, vol.48, n.4, pp.179-184. ISSN 0001-6002.

Aim: To characterize the hospitable debits by VIH/AIDS in the Hospital Mexico, and to evaluate the repercussion that the antiretroviral therapy (ARVT) has had in the probability of re-hospitallization by opportunistic diseases in these individuals. Methodology: the data of all the withdrawn patients of the Hospital Mexico were compiled with HIV/AIDS diagnosis between January of 1995 and April of the 2003. The descriptive analysis of the information was made using software SPSS version 12.0 with the calculation of the measures of central tendency and dispersion for the quantitative variables and calculation of the frequencies for the qualitative variables. The calculation of the survival analysis was made by the software Minitab vesión 12,2 with the definition of a statistical significance level of smaller or equal to 0.05. As inclusion criterion all the patients selected themselves who withdrew alive of their first hospitalization with the HIV/AIDS diagnosis and divided in two groups according to the year of their entrance and its exhibition to ARVT .The first group corresponds to the period of January of 1995 to December de1997 and not exposed to ARVT, the individuals of the first period that initiated ARVT were excluded from the analysis. The second period of 1998 to April of 2003 involves the hospitable debits with HIV/ AIDS diagnosis. Results: The data of 1081 debits corresponding to 623 patients, 85,7% men were analyzed, with an average age of 36,8 years, 69,8% were unmarried. The average of hospitalizations per year was of 70,9 patients. Observed general mortality was of 30%, but it was observed in same a tendency to diminish. Only 42,5% of all the debits corresponded to direct insured. The Kaplan Meier analysis revealed that the average to develop a second opportunistic disease was of 466,2 days (IC_95% 382.8-549.7) for the group without ARVT and of 1050,5 days (IC95% 952.1-1148.9) for the group under the therapy with significant differences between both periods (Log Rank, p<0.05). This result was influenced neither by the basal level of CD4 nor by the basal viral load. Conclusion: The number of hospitable debits by VIH/AIDS continues increasing. One is a young population, in his majority men, unmarried. Intrahospitable mortality is high, although it has tended to diminish. The survival analysis verifies the effectiveness in our means of the antiretroviral therapy to diminish the occurrence of new opportunistic infections and new hospitalizations.

Palabras clave : Antiretroviral therapy; HIV; AIDS; oportunistic infections.